High-Resolution Holter 12-lead ECG from Chest Pain Patients

IDENTIFICATION : E-HOL-12-0171-014

Study Design: Tthe Ischemia Monitoring and Mapping in the Emergency Department in Appropriate Triage and Evaluation of Acute Ischemic Myocardium (IMMEDIATE AIM) study is a prospective trial. Patients were enrolled in the study between 2002 and 2004 and 1-year follow-up was completed in December 2005. The overall goal of the IMMEDIATE AIM study was to improve the noninvasive electrocardiogram (ECG) diagnosis of patients who present to the ED with acute coronary syndrome. Specific aims were to (1) acquire continuous, 24-hour, standard 12-lead ECG Holter recordings in cohorts of ED patients undergoing evaluation for possible acute coronary syndrome, (2) simultaneously acquire continuous, 24-hour Holter recordings from electrode sites considered optimal for ischemia detection (Fig. 1) and then estimate body surface potential maps (EBSPM),
and (3) compare the sensitivity and specificity of standard electrocardiography with the EBSPM method for identifying acute myocardial ischemia and infarction.

Study Population:

Average of Age

Gender

FinalDx

f

m

Grand Total

Non ACS

67.3

63.0

65.6

Non-cardiac

60.7

60.2

60.5

Non-ST Elev MI

73.3

75.0

73.5

ST-Elev MI

66.5

66.5

Unstb Angina

65.7

63.8

64.5

Grand Total

65.5

63.1

64.4

Count of Gender

Non-cardiac(1)

FinalDx

0

1

Grand Total

Non ACS

82

82

Non-cardiac

46

46

Non-ST Elev MI

9

9

ST-Elev MI

6

6

Unstb Angina

28

28

Grand Total

125

46

171

ECG Number of Leads: 12 lead standard configuration

ECG Sampling Frequency : 1000Hz

ECG Amplitude Resolution: 3.75 uV

File Naming Convention: Each filename is composed by a unique "ID".

Clinical Information:

Age (yrs)

Gender (m/f)

Race: (Racial Categories): 0=Unknown
1=American Indian or Alaska Native: A person having origins or any of the original
peoples of North, Central, or South America; and who maintains tribal affiliations or
community attachment.
2=Black or African American: Persons having origins in any of the black racial groups of Africa. Terms including Haitian or Negro can be used in addition to Black or African American.
3=Asian: Persons having origins in the Far East, Southeast Asia, or the Indian subcontinent including Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
4=White: A person having origins in Europe, the Middle East, or North Africa.
5=Pacific Islander: Persons having origins in any of the Hawaiian islands, Guam, Samoa, or other Pacific Islands.

Latino: (Ethnic Categories): Mark Yes to this question if the patient is of Latino, Hispanic, or Spanish origin. This is defined as a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

51. Final Diagnosis: Final diagnosis from this hospitalization taken from the discharge summary
0=ST Elevation MI (If type of MI is unclear on the discharge summary refer to Kirstens diagnosis of the Initial ECG if marked positive for ST elevation then the MI is coded as a ST Elevation MI if not the MI is coded as a Non-ST Elevation MI)
1=Non-ST Elevation MI
2=Unstable Angina (Under the ICD 9 code system Intermediate Coronary Syndrome as Unstable Angina, in addition any clinical course that describes unstable angina should be coded as such
3=Non-Acute Coronary Syndrome CV Condition (excludes MI or unstable angina); e.g. valvular heart disease, CHF, pericarditis, new onset arrhythmia, stable angina, HTN crisis, aortic dissection or aneurysm, etc. Under the ICD 9 code system Other Chest Pain, Atypical Chest Pain, and Unspecified Chest Pain should be coded as a Non-ACS Syndrome.
4=Non-Cardiac Condition; e.g. pneumonia, CVA, GIB, DKA, Hyperkalemia, sepsis

CV Medical History:Indicate conditions present in the patients past medical history obtained from the physicians notes

LAD: Left Anterior Descending (includes the main LAD or any of its branches such as the diagonals and ramus intermedius)

RCA: Right Coronary Artery (includes the main RCA or any of its branches such as the right ventricular or acute marginal)

Left Circ: Left Circumflex (includes the main LCS or any of its branches such as the obtuse marginals or posterolateral),

Left Main

Complications during Hospitalization:Cardiac Arrest Cardiogenic Shock Severe Heart Failure/Pulmonary Edema new development after admission Extension of MI: only possible for patients that were admitted with AMI diagnosis
By a re-elevation of cardiac enzymes, CK and CK-MB

Hx of Hypercholesterolemia: 1) documented serum cholesterol 240mg/dl or 2) prior diagnosis by a physician when the patient cannot remember an exact value or the value is not recorded in the patients previous medical record or evident by medication history.

Hx of Hypertension: evidence or knowledge of hypertension prior to this acute event, treated or untreated with medication

Current Smoker: Is the patient a current smoker (mark yes if quit 1 week ago)

Diabetes: evidence or knowledge of diabetes mellitus treated with insulin, oral agents, or diet alone prior to this acute event

Death : Mark if the patient died during this hospitalization due to CV causes, e.g. cardiogenic shock, AMI, CHF, VF arrest, etc.